Apprehension and Relocation

 Apprehension and Relocation

What is Apprehension and Relocation Test of the shoulder?

See Also: Anterior Shoulder Instability

How do you Perform the apprehension and Relocation test?

The examination begins with the patient seated:

The Apprehension and Relocation test can also be performed in the supine position with improved muscular relaxation:

What does a positive Apprehension and Relocation mean?

Anterior shoulder pain with reflexive muscle tensing is a sign of an anterior instability syndrome.

Jobe Relocation test:

Sensitivity & Specificity

A study by Vincent A. Lizzio1 to evaluate the patient with suspected or known anteroinferior glenohumeral instability, he found the Sensitivity and Specificity of the Apprehension test as following:

and for Relocation test:

Notes

A traumatic anterior instability of the shoulder can lead to injury of the posterior structures. Thus, the clinician must always be aware of potential injuries on the opposite side of the joint even if symptoms are predominantly on one side. In addition, if a joint is hypermobile in one direction, it may be hypomobile in the opposite direction. For example, with anterior instability, the posteroinferior capsule tends to be tight and therefore requires mobilization, whereas the anterior capsule is hypermobile and requires protection.

Reference

  1. Vincent A. Lizzio, Fabien Meta, Mohsin Fidai, and Eric C. Makhni. Clinical Evaluation and Physical Exam Findings in Patients with Anterior Shoulder Instability. Curr Rev Musculoskelet Med. 2017 Dec; 10(4): 434–441. PMID: 29043566
  2. Clinical Tests for the Musculoskeletal System 3rd Ed. Book.
  3. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.


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